Ocular Diseases (Onchocerciasis, Loase, pterygium, cataracts)

 

Onchocerciasis (river blindness)

Eye injuries, due to the presence of microfilariae in the eye, usually occur in adulthood and progress to blindness in the absence of early treatment.

Clinical features and treatment:

Ocular lesions are always associated with extra-ocular lesions of onchocerciasis.

– Ocular pruritus, night blindness (loss of night vision), decreased visual acuity, visual field constriction, patient perception of microfilariae in the visual field (the patient sees “little snakes moving before the eyes”).

– Lesions of the cornea (punctate keratitis and sclerosing), iris (iridocyclitis), posterior segment (chorioretinitis, optic nerve atrophy); microfilariae in the anterior chamber or vitreous (slit lamp).

For treatment, see onchocerciasis. Ivermectin can sometimes regress anterior segment lesions (sclerosing keratitis, iridocyclitis) and improve visual acuity. Severe lesions (chorioretinitis, optic atrophy) continue to evolve despite treatment.

Loase

Clinical features and treatment:

Passing under the palpebral or bulbar conjunctiva of adult worm (white worm, skinny, long March to July cm, highly mobile), accompanied by ocular itching, tearing, photophobia, or edema.

For treatment, see loiasis. The passage of the worm is often very fast, do not try to squeeze, do not administer anesthetic eye drops; reassure the patient, the incident Benin. The extraction is also unnecessary if the worm is dead / calcified.

Pterygium

Whitish triangular conjunctival membrane, moving very slowly towards the cornea.

The arid climate, dust and wind favor its development. Its regression is never spontaneous.

Clinical features and treatment:

There are two stages:

– Benign pterygium develops slowly, does not reach the pupil uncomplicated: no treatment.

– Vascular pterygium develops covering the pupil, conjunctival redness, discomfort vision, tearing:

• Clean the eye with sterile water or sodium chloride 0.9%.

• At this stage, the treatment should be surgical, depending on local possibilities.

Cataract

Clouding of the lens resulting in progressive loss of visual acuity.

Cataracts are common in the tropics and appears earlier than in Europe.

The achievement of both eyes leads to blindness, only curable surgically.

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